NBME 9 questions with complete solutions

NBME 9pt who had an organ transplant (or stem cell transplant) present with left-sided face & UE weakness and MRI of brain shows mass ( can be other places outside LN). biopsy of lesion shows proliferation of monoclonal B lymphocytes. which virus is the causes? - correct answer Epstein-Barr virus - can cause post-transplant lymphoproliferative disorder in pts on immunoassays for organ transplant - to treat reduce dosage of immunosuppressants they are on , can add rituximab. What are the levels of Indirect Bilirubin, Lactate dehydrogenase, alk phos, during hemolysis? - correct answer indirect bilirubin and LD increased alk phos normal ( this would be increased in biliary obstruction, which this not) what is the drug to treat acute dystonia from antipsychotics (2) - correct answer 1) benztropine 2) diphenhydramine these are anticholinergics 4 drugs that are the best for bipolar depression ( key depression) - correct answer 1) lithium 2) lamotrigine 3) quetiapine 4) lurasidone next best step in diagnosing Botulism - correct answer repetitive nerve stimulation study - will show low amplitude that improves with repeated stimulation what drug should you pt with afib to prevent thromboembolic recurrent strokes - correct answer warfarin(anticoagulant) - note, aspirin and clopidogrel(antiplatlets) are given to those without afib who had TIA/stroke, to prevent recurring stroke